A version of this post was sent to the Tempe City Council with a underwhelming response. The fight to normalize massage regulation in AZ is a complex one that will require buy in from Therapists.

In Arizona, Massage Therapists are regulated at the state level. In order to provide massage services one must meet minimum educational standards and pass a background check. If a therapist works outside of their scope of practice or commits a crime the State Massage Board can and does investigate these cases and may revoke or suspend a therapist’s license. If the action is criminal, such as prostitution or inappropriate sexual contact with clients, therapists can and are prosecuted through the courts. In most states this is considered enough to ensure the safety of massage consumers.

City permits—why massage?

In order to operate a massage business in any city in the Phoenix metro area, one must obtain a permit from the city in which one wishes to practice. The cost of this permit is anywhere between $200-$500 depending on the city. The city of Tempe also requires a “Special Use Permit” for massage regardless of the type of zoning. So to operate a massage office in Tempe costs an additional $1,200 in order to have even one room in a wellness center or multi-use office for massage. In most cases these fees and regulations are applied across the board whether the therapist is working solo, one or two days a week, or running a large spa.

These fees are per location and therapists are required to pay them again if they move offices, even within the same complex. Therapists who sublease—a common occurrence among massage therapists -- are at the mercy of the person they are subleasing from in a way most other providers are not. Subleasing from another health professional who decides to move means tough luck for the therapist will have to pay another $1,400 and wait up to 3 months for a new location; another healthcare professional can simply sign a new lease, move, and continue their business.

Other businesses required to secure these additional permits include escort services, pawn shops, or adult business. You may notice no other healthcare provider is on the list. Moreover, aestheticians, nail salons, stylists, and barbers are not required to obtain a city permit. Personal trainers and reflexologists are also not required to obtain any kind of special permits—and they have no state licensing board to go after them, if they commit any ethical infractions in their practice. So, while a person without a professional license can offer table stretching and a foot massage without a permit, I have to pay a hefty fee and be fingerprinted at the police station every year in order to do so.

Odd rules

Some of the odd city level massage rules include: “It shall be unlawful for any massage establishment to conduct or operate on the same premises whereon is also conducted the business of a cocktail lounge, photography studio, model studio, art studio, telephone answering service, motion picture theater or adult-oriented business.” (Tempe). A code requiring a therapist to turn over a client’s full legal name and address to the city upon request. (Chandler). A rule which at first blush seems benign makes it illegal to ask a client to touch his or her genitals or breasts (Mesa) – but that also prevents a therapist from asking a client to move his or her genitals or breasts out of the way in order to professionally massage the clients chest or inner thigh without touching their genitals. A license groups together “Adult Business, Escort, Massage Therapy Establishment.” (Gilbert).

Most of these rules seem to start off at the assumption that therapists are by default prostitutes and that cites can somehow legislate this activity away line by line. As most are aware, those committing criminal acts do not follow the law, and massage therapists would find these rules insulting and at times difficult to follow or confusing. Additionally, I can’t see a way many of these rules could be enforced without a camera in the treatment room.

The nature of massage work.

Most massage therapists work no more then 25 hours a week, are women, and work in the profession for fewer than 4 years. Therapists are also largely self employed. Massage therapists are not a group likely to start and maintain a successful lobbying effort. It is not surprising, therefore, that therapists are not organized in a way they can quickly respond to onerous legislation and regulation.

Additionally, it is normal for therapist to work as independent contractors in a variety of locations, one or two days in a spa, a day in a medical office, one day in a gym etc. I personally have had to turn down one day a month gigs at a yoga studio, birth center, lactation office, Crossfit gym, midwifery office, and aesthetician's office because these would cost $100 each and require 3 months to approve. Several of these locations have moved on to invite a therapist who did not insist on going through the licensure/ zoning process.

Many therapists do massage as a part-time job, side job and are not the primary breadwinner in their family. In most cases these city regulations and fees are the same for a solo therapist working one day a week and a large spa employing ten plus therapists. Many solo therapists are not skilled in managing a business, nor do they have the income to hire someone to look into permits and regulations. Cities also make no effort to make businesses aware of these special permits. As a result there is very low compliance. Many therapists I have spoken to, even those with fairly busy practices do not have the financial capacity to go through these processes. As a result, even if they are aware of it, many therapist choose to ignore city level permits and licensure, and instead count on the low enforcement.

The low enforcement and awareness of city level regulation creates a uneven playing field for therapists who choose to comply with these city regulations. In my experience “what?“ and "they don’t enforce that" are common responses to conversations about city massage laws.

What is the solution?

No one is more motivated to end sex workers and traffickers using massage as a cover for their criminal activities then massage therapists. Public confusion between therapeutic massage and sex work/trafficking at the very least creates awkward encounters for us, and at the worst endangers our safety. Cities should be able to work with therapists to create regulations that work towards everyone's goals.

Some ideas for this would be creating a registry of Massage Therapists without the huge burdens attached so police can keep an eye out for suspicious practices. Additionally, different regulations for solo therapists versus large spas, and exemptions for therapist working in medical settings, could promote the small business growth being suppressed by the current regulatory regime.

As a therapist, I would rather spend my time working for things such a such as expanding our scope of practice to allow some teaching of exercises and increasing relationships with other health care providers. Instead we are working to validate our profession on the simplest of terms—every therapist is not a potential criminal as these city laws imply.